Increasing efficacy of endovascular recanalization with covered stent graft for TransAtlantic Inter-Society Consensus II D aortoiliac complex occlusion

Abstract

At 2 years of follow-up, the results of endoluminal bypass grafting with the Viabahn stent to treat complex aortoiliac disease are promising. Longer-term results are needed to fully evaluate the potential benefits and longer-term patency.

Editor's Choice – Outcomes of Self Expanding PTFE Covered Stent Versus Bare Metal Stent for Chronic Iliac Artery Occlusion in Matched Cohorts Using Propensity Score Modelling

“…In particular, for long occlusions a CS was preferred, because it allows flow restoration creating a new endo-conduit from healthy to healthy vessels (from the aorta to the femoral artery), mimicking the concept of the traditional aorto-bifemoral bypass. This technical choice is corroborated by the excellent results obtained by Psacharopulo et al, 12 which demonstrated similar 2 year primary patency using this approach compared with standard open repair (91% vs. 95%).…”

Patency and limb salvage after femoral endarterectomy and iliac stenting are not affected by severity of iliac disease

“…Interestingly, in a study by Humphries et al 7 in 2014 looking strictly at percutaneous iliac artery interventions, the use of covered balloon-expandable stents conferred a reduction in patency rates compared with bare-metal balloon-expandable stents. In two separate series by Piazza et al 8 and Psacharopulo et al, 9 it was demonstrated that covered stents for severe iliac lesions had patency rates similar to those of bare-metal stents. However, when both of these groups of investigators looked specifically at long-segment TASC D lesions, covered stents actually had better patency rates than baremetal stents in this subgroup of patients.…”

Leriche Syndrome: Percutaneous Treatment with Mechanical Thrombectomy: A Case Report

“…Furthermore, open reconstructionsare related to higher operative morbidity, mortality [11,12], length of hospital stay [9,13] and short-term costs [14]. Evaluating percutaneous treatment, the risks of renal insufficiency, embolization and access complications are not insignificant; however, they can be prevented or managed without significant clinical consequence.…”

“…In some situations, due to anatomic considerations or clinical risks, an axillo-bifemoral or a unilateral axillo-femoral/aorto-femoralbypass with a femoro-femoral crossover may be used. Long-term primary patency rates for open bypass are undoubtedly superior to endovascular intervention [9]; however, secondary patency rates are comparable [5][6][7]10].…”